1. Field of the Invention
The present invention relates to an intubating assembly structured to facilitate the safe, rapid and aligned positioning and introduction of an intubation tube into a trachea of a patient in a manner which minimizes the risk of accidental introduction of the intubation tube into the esophagus, pyriform sinus or vallecula of the patient by guiding the intubation tube through the airway of the patient until it may be directed specifically into the trachea.
2. Description of the Related Art
Frequently, patients undergoing medical treatment and patients in emergency situations experience some form of trauma and/or medical problem that tends to require that they have some breathing assistance or control. As a result, it is frequently necessary to intubate a patient immediately at an emergency site in order to resume breathing, or in a surgical setting when respiratory muscles must be paralyzed.
Specifically, endotracheal intubation of a patient involves the introduction of an elongate, tubular intubation tube through the mouth of a patient and into the trachea of the patient for communication with the lungs of the patient. Once effectively positioned, the intubation tube is connected with a conventional ventilator assembly and is utilized for continuous, direct ventilation of the patient. Unfortunately, however, proper introduction of the intubation tube into the patient's airway can be quite difficult, and often involves extensive training in specialized techniques in order to accomplish it rapidly and effectively.
The most common techniques taught to hospital workers, and especially to emergency medical technicians (EMTs) who must introduce intubation tubes in a rapid, emergency situation, usually require a patient's head be tilted, in order to generally align the patient's mouth with their trachea, followed by a direct introduction of the intubation tube into the patient's airway. While these techniques are theoretically quite effective, normal anatomical limitations in the positioning of the patient's head make it such that direct alignment can generally not be achieved, especially if limitations on the movement of the patient's head are present, and some further manipulation of the intubation tube within the airway of the patient is required. As a result, the most commonly employed technique further involves the grasping of the intubation tube between the technician's fingers and manually introducing the fingers and the intubation tube into the patient's airway as far as possible in order to generally guide the tip of the intubation tube towards the trachea. Still, however, such manual introduction techniques can be quite difficult. For example, unless a technician has generally long fingers, optimal access into the patient's mouth cannot be achieved, and the added width of the technician's fingers may tend to create a tight fit through the patient's mouth, thereby limiting manipulability and further limiting introduction depth. Further, if the patient is conscious, manual introduction can be hazardous to the technician as they are susceptible to being bitten during intubation. Moreover, even with manual introduction, a certain degree of "feeling around" within the patient's airway is still required. Furthermore, because of the degree of head extension necessary for effective intubation, either manually or using some known device, the patient's teeth are often broken because of the force required to manipulate the lower jaw, especially when performed by less experienced clinicians.
As such, a primary reason for the difficulty associated with the accurate introduction of an intubation tube relates to the unavoidable limitations of the human anatomy. Specifically, in addition to limitations associated with opening the mouth to a sufficient access orientation, continuous with a roof of a patient's mouth is the esophagus. As such, if the intubation tube is merely driven along a roof of the mouth, improper intubation into the esophagus will almost certainly be achieved. Conversely, if the intubation tube is driven over the tongue and down a bottom of a throat, a patient's vallecula, a short passage bordered by the epiglottis, is positioned such that intubation into the vallecula will generally result. Indeed, the epiglottis is seen to extend out into the airway so as to effectively guide the intubation tube into the vallecula if the tip of the intubation tube is not generally spaced from the bottom of the patient's mouth and throat. Accordingly, due to the various passages and contours associates with the human anatomy, an effective device which can provide for consistent and rapid introduction of the intubation tube into the appropriate passage, namely the trachea, will be highly beneficial.
Others in the art have sought to provide devices which can more effectively provide for the introduction of an intubation tube. Typically, however, these devices involve some manipulation of the epiglottis and/or vallecula and can independently cause trauma to the patient. More importantly, however, such known devices are often quite large and bulky, and are therefore very difficult to effectively introduce into the patient's airway through the patient's mouth, while still permitting room for manipulation of the intubation tube. For example, one conventionally implemented device includes an elongate, straight "blade" type element which pins the epiglottis down into the vallecula, thereby sealing off the vallecula and providing for straight introduction of the intubation tube along a base of the throat. Unfortunately, however, such a device still requires safe extension thereof beyond the epiglottis, in the same manner as would be required with the intubation tube itself, in order to effectively pull back on the epiglottis and pin it down within the vallecula. Therefore, while facilitating the introduction of the intubation tube, the device itself includes the same problems with proper positioning which are associated with introduction of the intubation tube, namely extending beyond the epiglottis and vallecula, towards the trachea in order to pull down the epiglottis. Conversely, another device which has been developed in an attempt to facilitate introduction of an intubation tube includes a tab-type element which is to be introduced into the vallecula, and thereby abuts the epiglottis. This device includes an internal guideway through which the intubation tube extends, with the tab element extending separately therefrom. Due to the required configurations so as to mate with the vallecula, while sufficiently protruding therefrom in order to provide for effective spaced positioning of the guideway in order to achieve guidance of the intubation tube over the epiglottis, such devices are quite large and bulky, and are very difficult to fit into the patient's mouth, especially if the patient is conscious and traumatized. Moreover, once the intubation tube is positioned, such devices can prove very difficult to remove without pulling on the intubation tube, as they are often very close to a size of a patient's mouth and can pin the intubation tube when being manipulated during withdrawal.
Accordingly, there is still substantial need in the art for an effective device which can substantially assist the introduction of an intubation tube into a patient and does not require over extension of the patient's head, or cause trauma to the patient during use. Such a device should be substantially compact, easy to manipulate, and substantially precise, thereby providing for rapid, safe and effective introduction of an intubation tube, even in emergency situations wherein immediate intubating in order to provide for ventilation of a patient is required, while maintaining the head in a more neutral position. Furthermore, use of such a device should be easily trained, with consistent, accurate results occurring during each use.